I
really liked Jonah’s post at The Frontal Cortex,
about
href="http://scienceblogs.com/cortex/2007/03/dreaming_smelling_and_memory.php">Dreaming,
Smelling and Memory. But I have to take issue with
his treatment of the use of dream interpretation in Freudian
psychotherapy.

I know this is a nit-picky point, and is completely tangential to the
point of his post. But this close to Piday, we need to be
thinking about things like tangents.

It is true that psychoanalysts refer to dreams as “the royal road to
the unconscious.” It is true that the interpretation of
dreams can be an important part of
href="http://en.wikipedia.org/wiki/Psychoanalysis" rel="tag">psychoanalysis.

However, I would argue that the origin of dreams is irrelevant to their
application in psychoanalysis.

Maybe
dreams are just random neuronal activity. Maybe they serve a
specific function that is not related to whatever neurosis the person
may have. None of that matters. What matters is
this: is there therapeutic value in the interpretation of dreams?

In psychoanalysis, analysands (patients) are encouraged to report their
dreams, with as much detail as possible about anything potentially
symbolic. Then they are to engage in free association in
response to the symbols.

People can debate this all day long, but my impression is this: it is
the process of engaging in free association, in response to symbols
that the analysand chooses as significant, that is therapeutic.
There is nothing particularly important about the symbols
themselves. The benefit is derived entirely from the process.

I am hopeful that it is obvious, that what I’ve said about the process
of interpreting dreams is a gross oversimplification.
People could write books about what therapists consider the
process. Note that in the context of psychoanalytic theory,
the term interpretation and process
have very specific technical meanings. Just as the word force
has a general meaning in everyday discussion, and a specific meaning in
physics. Understanding the everyday usage tells you little about the
technical meaning of the term.

So scientists of various stripes may dismiss the content of dreams as
unimportant. Or they may find that the content serves a
specific purpose with respect to the consolidation of memory.
Or it might serve as a mechanism to manage stress.
Or any of a number of things. But none of that has
anything to do with the therapeutic value, or lack of value, in the
interpretation of dreams.

Comments

Joseph – I’m still in the dark about how you would answer the question you pose: Is there therapeutic value in the interpretation of dreams?”

It’s been a long time since I’ve seriously studied the concepts and methods of psychoanalysis (with Adolph Grunbaum, so maybe my exposure was a bit one-sided). But I vaguely recall a few studies comparing outcomes for competing psychotherapeutic methods, which weren’t very flattering of psychoanalysis, or “talking cures” generally.

First, let me clarify: psychoanalysis is a specific form of psychotherapy. The patient is seen four to five times per week, usually over a period of five years or more. It suffers from a number of drawbacks. One, it is enormously expensive, but in terms of money, and also time. Two, relatively few patients are suitable for this form of therapy, and the intersection set of the number of suitable patients, and the number who can afford it, is extremely small. Three, it is inherently difficult to study scientifically. Not only is each patient different, but each instance of treatment is different. As a result, studies tend to consist of an N of 1. Many several similar cases may be grouped together, but then it is a group of similar N=1 cases.

In psychopharmacology, it is axiomatic that you never learn anything from an N of 1.

Dream interpretation is said to be a useful part of psychoanalysis. However, I cannot vouch for that. Psychoanalysis is such a specialized field that even most psychiatrists these days don’t know much about it.

Psychoanalysis originally was overly ambitious. It was intended to be a sort of “theory of everything,” in that it was though that it could explain all forms of psychopathology. That was plainly incorrect. There are many people who still believe in it as a form of therapy, but I would not claim to be able to say whether there is any substance to that.

I will say that we did learn a lot from the practice, but in my opinion, it is time to move on.

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